Objective To evaluate the sensitivity and optimized scanning parameter of 64-slice spiral CT in detection of pulmonary nodules with different size and density. Methods Three groups of prosthesis nodules with diameter of 2.5～13 mm and different density (soft-tissue, low density, and ground glass opacity,GGO)were taken into the chest phantom equivalent to human tissue,then scanned with Philips Brilliance 64 scanner in standard dose(tube voltage:120 kV, tube current: 250 mAs)and low-dose(tube voltage:120 kV, tube current: 50, 30,and 21mAs) respectively. The radiation dose(CTDIw and DLP) of the scans, Hounsfield unit(HU) and standard deviation(SD) of CT values in different regions of the phantom, and visibility of the nodules was assessed and recorded.Results The radiation dose of 64-slices spiral CT scanning in low-dose(tube current 21～51 mAs) decreased to 8%～20% of which scanning in standard-dose(250 mAs). There was no statistical difference between the CT values in different regions of the phantom (P>0.05), while the SD of CT values was of statistical significantce (P<0.001) and SD increased with the increment of the density under different scanning parameters. None of the nodules besides of GGO nodules with 2.5 mm and 4 mm in size scanned at 21 mAs was invisible. Conclusion GGO nodules of 2.5 mm in diameter can be detected with 64-slice spiral CT using 30 mAs at experimental study, which might be the optimized dose for detecting pulmonary nodules.

Objective To analyze the image noise and artifact of low-dose chest CT scanning and the distribution pattern. Methods A chest phantom equivalent to human tissue was scanned by 64 slices spiral scanner at standard dose (250 mAs) and low-dose (50, 30,and 21 mAs) respectively, HU in sites of the phantom and SD of which was recorded. 200 patients with pulmonary nodules were scanned at 30 or 21 mAs for minimal length. The relationship between severity of noise and artifact in chest low-dose CT scanning and gender or body mass index (BMI) of the patients, as well as the distribution of noise and artifact was evaluated. Results There was no statistical difference between the HU in sites of the phantom: lung (-777.3-- -758.2 HU, F=0.992, P<0.01), chest wall (107.9--111.3 HU, F=2.044, P>0.05), vertebra (835.6--875.3 HU, F=1.453, P>0.05), while the SD of which was of statistical signification: lung (9.5--29.0 HU, F=108.7, P<0.01), chest wall (10.1--32.4 HU, F=84.3, P<0.01), vertebra (19.2--57.1 HU, F=30.6, P<0.01),tbe SD increased with the decrease of the tube current. There was no statistical difference between male (in which 74 cases no or mild, 17 cases severe)and female (81 cases no or mild, and 28 cases severe)in image noise and artifact in low-dose images (X~2=2.294, P>0.05), and significant difference between groups of different BMI(in BMI<18.5 group, 29 cases no or mild,2 cases severe, in group of 18.5≤BMI<24.0, 120 cases no or mild, 13 cases severe, and in group of BMI≥24.0, 6 cases no or mild, 30 cases severe, X~2=128.274, P<0.01). The noise andartifact was greater in the upper (80 cases no or mild, 38 cases severe, X~2=18.918, P<0.01) and dorsal field (89 cases no or mild, 33 cases severe, X~2=6.760, P<0.05). Conclusions The image noise and artifact was significant in low-dose CT, especially in the dorsal and upper field of the lung, which might be attributed to the distribution of skeleton in the chest. It was recommended that scanning protocol (mAs value) be individualized adjusted in according to the patients BMI.

Objective To study X-ray, CT and MRI features of the spinal giant cell tumors (GCT)and to assess the clinical applied value.Methods Thirty cases of GCT of spine (13 males and 17 females with ages ranging from 17 to 69 years) were reviewed. Allcases underwent radiography,CT was done in 22 patients and MRI was performed in 16 cases.Results One lesion localized in cervical spine,10 in thoracic, 6 in lumbar and another 13 lesions in the sacrum.Osteolytic destruction and vertebral compression were seen on X-ray film. The main CT signs were expanding bone destruction and soft tissue mass. MRI showed low to intermediate signal intensity on T_1WI while high signal on T_2WI.Conclusion X-ray, CT and MRI are of significant value in diagnosis of the spinal GCT, and play an important role in surgical planning.

Objective To observe the effect and safety of low dose milrinone used in patients suffering from refractory heart failure and renal dysfunction. Methods Forty-two patients with refractory heart failure and renal dysfunction were divided into treatment group(21 cases ) and control group(21 cases )by random digits table. All the patients accepted a therapy of cardiac booster, diuretics and vasodilators, and treatment group also accepted the therapy of milrinone [0.375 μ g/( kg· min), 10 mg/d, for 7 days]. And then the symptom, signs, blood pressure, heart rate, heart function and renal function before and after the treatment were observed. Results The total effective rate in treatment group was 85.7%( 18/21 ) ,significantly higher than that in control group [57.1% (12/21)] (P ＜0.05＝. After treatment,the heart rate,systolic blood pressure,diastolic blood pressure,stroke volume,cardiac output and left ventricular ejection fraction in treatment group and control group improved significantly than those before treatment, and these index improved better in treatment group [(79.3 ± 12.4) beats/min vs. (85.4 ± 10.2) beats/min, ( 107.6 ± 15.4)mm Hg ( 1 mm Hg = 0.133 kPa) vs.( 119.1 ± 13.5 ) mm Hg, (60.8 ± 9.4) mm Hg vs. (65.8 ± 8.5 ) mm Hg,(66.3 ± 10.2 ) ml vs. (61.2 ± 9.3 ) ml, (5.3 ± 0.6 ) L/min vs. (4.8 ± 0.9) L/min, (56.6 ± 8.4 )% vs. (48.9 ±7.3)% ,P ＜ 0.05＝. In two groups,there were no statistical difference in renal function. Conclusions Low dose of milrinone can improve the heart function of the patients with refractory heart failure and renal dysfunction and has good renal safety.

Objective To explore the ziggy joint amomum six columns nai jun pill in patients with diabetic nephropathy urinary inhibition c and serum c-reactive protein levels.MethodsSelect 80 patients with diagnosis of diabetic nephropathy, randomly divided into 2 groups, 40 cases in each group.Craig column nai treatment, control group given on the basis of the observation group in the control group given six jun pill treatment, treatment of 12 weeks, before and after treatment were detected blood glucose (FBG), glycosylated hemoglobin (HbA1C), urinary inhibition c (CysC) and serum c-reactive protein (CRP) and 24 h urinary microalbumin urine trace albumin (24 hUAE) changes.ResultsCompared with before treatment, 24 hUAECysC, CRP and 2 group were lower (P< 0.05);Compared with control group, 24 huae CysC, CRP and the observation group were lower (P< 0.05), the clinical curative effect is higher (P< 0.05), and high safety.ConclusionZiggy joint amomum six columns nai jun pill treatment of the diabetic nephropathy is a effective way, and can significantly reduce serum CysC, CRP levels.

Objective To explore the effect of Shenshuaining capsule on nutritional status and blood rheology in patients with chronic renal failure.Methods 150 cases of chronic renal failure were randomly selected and were randomly divided into observation group and control group, 75 cases in each group.The control group were given hemodialysis for treatment,and the observation group was treated with Shenshuaining capsule one week after dialysis.The clinical effect,nutritional status and biochemical indicators in the two groups were observed.Results The total effective rate in the observation group was 86.67%, which was higher than 72.00% in the control group,the difference was statistically significant(x2=4.920,P<0.05).After treatment,the nutrition indicators of HBG,ALB,IgG,IgA and IgM in the observation group were (135.7±16.4)g/L,(34.5±2.9)g/L,(10.8±0.7)g/L,(2.1±0.4)g/L and (1.7±0.3)g/L respectively, which were higher than those in the control group[(113.8±16.9)g/L,(28.4±2.5)g/L,(7.6±0.8)g/L,(1.3±0.3)g/L and (1.2±0.2)g/L], the differences were statistically significant(t=8.054,13.797,26.070,13.856,12.010,all P<0.01).In the observation group,the incidence rate of undernutrition was 25.33%, which was lower than 46.67% in the control group, the difference was statistically significant(x2=45.905,P<0.05).After treatment,the blood urea nitrogen and blood urea in the observation group were (349±64)μmol/L and (10.4±3.7)mmol/L respectively,which were lower than those in the control group[(462±51)mol/L and (14.2±4.5)mmol/L], the differences were statistically significant(t=11.958,5.649,all P<0.05).After treatment,the creatinine clearance rate and concentration of hemoglobin in the observation group were (25.1±6.1)mL/min and (92.1±21.1)g/L respectively, which were higher than those in the control group[(21.7±5.4)mL/min and (84.7±15.3)g/L], the differences were statistically significant(t=3.614,2.459,all P<0.01).After treatment, the high blood viscosity,low blood viscosity,plasma viscosity and hematocrit in the observation group were (3.59±0.94)m/Pas,(7.84±0.97)mPa/s,(1.31±0.15)mPa/s and (0.33±0.07) respectively, which were lower than those in the control group[(4.41±1.13)mPa/s,(8.72±1.05)mPa/s,(1.43±0.24)mPa/s and (0.42±0.05)], the differences were statistically significant(t=11.958,5.649,2.459,all P<0.01).Conclusion For patients with chronic renal failure,Shenshuaining capsule combined with hemodialysis can improve the nutritional status and blood rheology.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome (PCOS).Methods Taking ESHRE/ASRM diagnosis as the gold standard,51 women with PCOS and 47 women without PCOS were selected and divided into the intervention group and control group respectively from the Department of Gynecology in the Second Affiliated Hospital of Kunming Medical University between January 2013 and July 2014.Logistic regression based on principal component analysis and significant variables chosen through single factor analysis were used to establish the new diagnostic model which combined reproductive indices and metabolic indices.We evaluated the validity and reliability of the new diagnostic model by using ROC curve analysis.Finally,we analyzed the consistence and difference between the new diagnostic model and the gold standard.Results Thirteen significant variables were chosen using single factor analysis.ROC analysis showed that an area under the curve was 0.976 (P＜0.001) and the optimal cut-off point was 0.526 with a sensitivity of 96.08％,a specificity of 93.62％ and a consistency of93.88％.The new diagnostic model had superior validity and reliability.The two diagnostic methods had strong consistence (Kappa=0.877,P＜0.001) and no difference (x2=0.167,P=0.688).Conclusion Considering that the integration of metabolic indices does not change the diagnosis result,we come to a conclusion that it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective To compare the clinical utility of CT-guided percutaneous biopsies for bone destruction. Methods The retrospective analysis of pathologic outcomes of 89 cases guided by X-ray and MRI, were obtained by needle aspiration (n=13) of 18-20G tru-cut biopsy needles (n=22) and 11-13G Ostycut biopsy needles (n=40). Results Seventy five (84.3%) patients with percutaneous biopsy outcome with concordant results from specimens subsequently obtained at surgery, 14 patients (15.7%) showed pseudo-negative results but no pseudo-positive cases. No obvious differences in pathological results were obtained among these three methods. Conclusions ① CT-guided percutaneous biopsy is effective in the evaluation of skeletal destructive lesions; ② Appropriate selection of percutaneous biopsy method for different kinds of lesion could raise the diagnostie accurracy.

Objective To evaluate the value of CT-guided biopsy of deep-located lesion in the diagnosis of lymphoma. Methods CT-guided percutaneous biopsy was performed in 58 patients with 16-20 gauge core-needle biopsy. The locations of lesion involved mediastinun, lung, retroperitonurn, spleen, kidney, adrenalal and musculoskeletal system. Pathology examination included hematoxylin and eosin staining and immunohistochemical assays. Results In 56 out of 58 cases,the biopsy findings could be confirmed by histologic examination including correctly diagnosed 47 malignant lymphomas, corresponding to a sensitivity of 81%;with fuithecmace subclassification 42 of the 47(89.4%) could be as diagnosed malignant lymphomas on the basis of CT-guided biopsy. Conclusions Biopsy of deeply located lymphoma mass under CT guidance has high diagnostic accuracy and low complication rate with convenience for subclassification of malignant lymphomas.

Objective To detect anti-clinically amyopathic dermatomyositis (CADM)-140 antibody in patients with dermatomyositis (DM) or CADM,and to estimate its clinical correlation.Methods Serum samples were collected from 22 patients with DM,16 patients with CADM,46 patients with other connective tissue diseases complicated by interstitial lung disease(including 8 cases of polymyositis,15 cases of systemic lupus erythematosus,5 cases of systemic sclerosis,6 cases of Sj(o)gren syndrome,6 cases of mixed connective tissue disease,6 cases of idiopathic pulmonary fibrosis),and 5 normal human controls.Enzyme-linked immunosorbent assay (ELISA) was performed with the recombinant melanoma differentiation-associated gene 5(rMDA)as a substrate to measure the anti-CADM-140 antibody in these serum samples.Clinical manifestations were compared between patients with anti-CADM-140 antibody and those without.Results The anti-CADM-140antibody was found in 43.8% (7/16) of patients with CADM and 9.1%(2/22) of patients with DM(P<0.05),but absent in the patients with other connective tissue diseases and in the normal human controls.A significant incroase was observed in anti-CADM-140 antibody-positive patients with DM/CADM in the incidence of cutaneous ulceration and necrosis,interstitial lung disease and rapidly progressive interstitial lung disease (8/9 vs.6.9%,P<0.01;9/9 vs.48.3%,P<0.01;5/9 vs.0,P<0.05),serum lactate dehydrogenase level(328.3±104.2 vs 241.1±100.3 IU/L P<0.05),erythrocyte sedimentation rate(40.8±23.1 vs.22.5±16.8 mm/1 h,P<0.05),high resolution computed tomography score(122.9±54.8 vs.70.0±59.8,P<0.05)compared with anti-CADM-140 antibody-negative patients with DM/CADM.The ereatine kinase level was significantly lower(156.3±260.8 vs.1806.2±3737.1 IU/L P<0.05)in anti-CADM-140 antibody-positive patients with DM/CADM than in anti-CADM-140 antibody-negative patients with DM/CADM,while no significant difference was noted in the positivity rate of antinuclear antibodies or incidence of malignancies between the antibody-positive and-negative patients with DM/CADM.Conclusions Anti-CADM.140 antibody not only is useful for the diagnosis of interstitial lung disease in patients with DM/CADM,but also may serve as a serum marker for rapidly progressive interstitial lung disease.Monitoring of serum anti-CADM-140 antibody might help to predict the progression of interstitial lung disease in patients with DM/CADM.